Podocyte hypertrophy in diabetic nephropathy

The development of irreversible renal changes in diabetes mellitus, such as glomerulosclerosis and tubulointerstitial fibrosis, are always preceded by the early hypertrophic processes in the glomerular and tubular compartment. However, the role of hypertrophy of podocyte in the diabetic nephropathy have not been fully elucidated yet. Observation came from a cross sectional study in diabetic Pima Indians suggests that subjects with clinical nephropathy had fewer podocytes per glomerulus than those without nephropathy. Since podocytes are thought to be incapable of replication, this observation suggests that podocyte loss, or perhaps a low podocyte number per glomerulus, contributes to the development and progression of diabetic glomerulosclerosis. Podocyte hypertrophy caused by high glucose concentration leads to podocyte loss and is a new insight of pathogenesis of diabetic nephropathy; and it also provides us with new therapeutic strategies in diabetic nephropathy.